Your thoughts please...

[chewymix]

Hi

Have have had chronic prostatitis / chronic pelvic pain syndrome for a little over 6 years and have lived with it OK with the odd bad flare here and there although never pain free, apart from virtually pain free in the morning. I have only EVER had pain, never the urological issues of chronic prostatitis / chronic pelvic pain syndrome or even the post void/ejaculation pain and for me the key killer is pain on sitting.

I have seen a few people about this and always drawn a blank and for me stretching and light exercise has definitely helped. I am now at the position where the 'next step' from a medical standpoint is to have an exploratory lap operation as there is a possibility that my pain could be being causes by inguinal hernia(s) - For me this nightmare began with a retracted testicle and from that event a pain in the left groin/perineum etc. In some sitting positions I can cause the left inguinal area/inner thigh to go numb which may indicate pressure on the genitofemoral nerve, which is also the nerve that feeds the creamaster muscle, so perhaps caused the retracted testicle all those years ago. The question is whats irritating this nerve and thats where this operation comes in. I am certain there is a muscular component as well as perhaps this nerve component as I think my pelvic floor is often contracted due to protection of this area.

My question is do you think its worthwhile me having this operation, its a lap procedure so no huge slices being taken out of me as in my mind if I dont have this done I will always wonder is this a hernia. If it turns out to not be then then I can focus on the pelvic floor issue, I think even if it does turn out to be this then I will have ongoing pelvic floor issues due to the length of time this has been going on.

The procedure itself is quite 'safe' in as safe as any operation that involves a general anaesthetic can be but also and I think importantly to me the guy who should be performing this has done over 2000 lap inguinal surgeries and countless other lap operations so is skilled and world renowned in his field.

I know this is a very subjective question but to me there are just too many questions unanswered without me going through with this even though that thought terrifies me I have spoken with others who have the pretty much pain free on waking but gets worse with sitting and have had hernia surgery who have become 'cured' by it. One of those also had a retracted testicle as a symptom so I feel I have to explore this, as alas all the stretching in the world will not fix a hernia, if I have one. . . . .

sorry its a ramble but I have been having a hard time mulling this one over recently.

thanks guys

[Jay]

Hi Chewy,

I'm not a doctor, and I'm certainly not a hernia expert. Others may be able to give you more worthwhile feedback. However, it's worth noting that many guys here seem to have had concerns about hernias at some point in their histories.

If there's any way they can possibly diagnose this without cutting, or at least get strong indications, I would go for that prior to having the procedure done. I'd hate to see you undergo a surgery which turns out to be unnecessary. I also know that hernias can be tricky to find, though, so that's a tough call.

[chewymix]

Thanks for the reply - I appreciate it and I know how difficult this is to offer advice on. Its likely I'll be having an ultrasound done to check for hernia however I have read that ultrasounds are not that great at detecting hernia's, to be fair no imaging is and ultimately I have been told that you'll never really know until they go in for a look.

I dont want to have to go that route but 6 years down the track I have to do something more

appreciate anyone else's thoughts/experiences

[Jay]

Just curious ...

I haven't read through your history, but have you had any professional physical therapy for your pelvic floor? I had issues with sitting at one point, and PT helped with that.

[chewymix]

Thanks again for the reply - I have seen Bill Taylor in Edinburgh a couple of times maybe 3. 5yrs ago, the main problem there is that I am in London and he Scotland, its not impossible but its not ideal. If I could self treat the sitting pain then I would be happy! I have no doubt that I have pelvic floor issues as when I saw Bill I had tenderness in a few spots but I wonder if this is my 'main' problem.

Lets see what the ultrasound shows up, if anything, but the nagging thing for me is an actual event seemed to trigger this in me and the sitting in certain positions 'causing' numbness in areas served by the genitofemoral nerve.

thanks again for the support.

[Jay]

Hi Chewy,

The fact that you had tenderness is possibly suggestive of something going on with your pelvic floor, and that situation can certainly change a lot in the span of 3.5 untreated years. If there is any way that you can manage it financially (maybe one of our European members will have travel advice), I would add another visit to Bill to your to-do list. See what he thinks.

The best place to go for self-treatment education is really Stanford, but that's a lot of money for anyone. I think Bill is pretty much the best option in your area of the world.

Good luck with the ultrasound, and with whatever path you choose to take. We are here for you. Perhaps others will chime in with their thoughts!

[webslave]

I think Bill may have improved in his knowledge and technique in the last few years, from what I've read. Chewy, don't get suckered into surgery until you've re-explored this option.